Healthcare management transferred to sub-national level

The government on Monday issued a sub-decree to delegate the management of healthcare provision to sub-national administrations, which will be effective as of January next year.

The sub-decree was approved by Prime Minister Hun Sen last Wednesday and signed by relevant ministers including Minister of Interior Sar Kheng; Minister of Economy and Finance Aun Pornmoniroth; Minister of Civil Service Pich Bun Thin; and Minister of Health Mam Bun Heng.

Consisting of eight chapters and 27 articles, the sub-decree aims to delegate decision-making and responsibility for the management of healthcare services to sub-national administrations, which will in turn bring it closer to the people.

Article 24 of the sub-decree states that the National Committee for Sub-National Democratic Development (NCDD) “must lead the facilitation with relevant stakeholders and sub-national authorities to prepare legal standard documents regarding the transfer of structure, personnel, financial resources and estate”.

Contents of the sub-decree must also be disseminated by year’s end.

Article 25 states that city and provincial administrations must manage and implement the tasks outlined in Article 4 from January 1, along with the delegation of management and responsibilities to districts and communes.

According to a statement by the Council of Ministers in October, the government plans to allocate 1,636,498 riel ($401 million) for the health sector next year, a five per cent increase on this year’s 1,545,525 riel (around $378 million) budget.

The Council of Ministers said the money would be used to “improve quality and strengthen healthcare, support an equity fund providing free healthcare to poor people and workers who are not under the National Social Security Fund scheme, and to provide to pregnant female workers until their children reach two years of age”.

Female workers who gave birth to one baby would receive $100, while they would receive $200 and $300, respectively, if twins or triplets were born. The government would provide around $40 to underprivileged women for pregnancy checkups and $50 when the baby was delivered, with $100 to be spent on baby care.

Advocacy and Policy Institute (API) director Lam Socheat welcomed the delegation of power to sub-national administrations as it would make access to health services easier. Nevertheless, he pointed out that this had come later than for other sectors.

“This is a positive development that we have been waiting a long time for. We as advocacy civil society want to see the transfer of functions, power and resources to bring services closer to the people.

“People have expressed their wish for more accessible public services. Provincial, district and commune councils should ensure that these services reach the people,” Socheat said.

He added that the delegation of power to the sub-national level empowers authorities to address problems more effectively. However, he cautioned that this move could face problems if it were improperly facilitated.